类风湿性关节炎患者超声滑膜血流特征、血清ANGPTL4、IL-18水平及临床意义  

Ultrasound synovial blood flow characteristics,serum ANGPTL4,IL-18 levels,and clinical significance in patients with rheumatoid arthritis

作　　者：刘一博 齐丹 郑冬 刘梦 傅群峰[1] 刘昕[1] LIU Yi-bo;QI Dan;ZHENG Dong(Department of Ultrasound,Baoding First Central Hospital,Baoding Hebei 071000,China)

机构地区：[1]保定市第一中心医院超声科,河北保定071000 [2]保定市第一中心医院骨科,河北保定071000

出　　处：《临床和实验医学杂志》2025年第4期430-435,共6页Journal of Clinical and Experimental Medicine

基　　金：河北省医学科学研究课题计划(编号:20220292);保定市科技计划项目(编号:2441ZF208)。

摘　　要：目的探讨类风湿性关节炎(RA)患者超声滑膜血流特征、血清血管生成素样蛋白4(ANGPTL4)、白细胞介素-18(IL-18)水平及临床意义。方法回顾性选取2022年1月至2024年1月在保定市第一中心医院治疗的RA患者94例作为观察组,同时选取健康体检者94名作为对照组。比较两组的超声滑膜血流特征、血清ANGPTL4、IL-18水平差异,以及观察组不同临床特征患者、治疗前后的超声滑膜血流特征、血清ANGPTL4、IL-18水平差异。采用Spearman秩相关分析超声滑膜血流特征、血清ANGPTL4、IL-18水平与28处关节疾病活动度(DAS28)评分的相关性。结果观察组超声滑膜血流特征分级高于对照组,血清ANGPTL4、IL-18水平分别为(45.50±11.02)ng/mL和(155.56±33.51)pg/mL,均明显高于对照组[(8.10±1.02)ng/mL、(35.58±7.28)pg/mL],差异均有统计学意义(P<0.05)。不同性别、年龄、体重指数患者超声滑膜血流特征分级、血清ANGPTL4、IL-18水平比较,差异均无统计学意义(P>0.05)。高度活动患者超声滑膜血流特征分级高于低度和中度活动患者,中度活动患者超声滑膜血流特征分级高于低度活动患者,差异均有统计学意义(P<0.05)。观察组高度活动患者血清ANGPTL4、IL-18水平分别为(68.08±11.14)ng/mL和(201.41±30.33)pg/mL,明显高于低度和中度活动患者,中度活动患者血清ANGPTL4、IL-18水平分别为(44.82±10.40)ng/mL和(151.18±32.20)pg/mL,均明显高于低度活动患者[(29.39±9.92)ng/mL、(128.38±28.38)pg/mL],差异均有统计学意义(P<0.05)。观察组治疗后的超声滑膜血流特征分级低于治疗前,血清ANGPTL4、IL-18水平分别为(20.40±9.93)ng/mL和(83.30±18.29)pg/mL,均明显低于治疗前[(20.40±9.93)ng/mL、(83.30±18.29)pg/mL],差异均有统计学意义(P<0.05)。超声滑膜血流特征、血清ANGPTL4、IL-18水平与DSA28评分呈正相关(P<0.05)。结论RA患者超声滑膜血流分级增强,血清ANGPTL4及IL-18水平明显升高,与患者疾病活�Objective To explore the ultrasound synovial blood flow characteristics,serum angiopoietin like protein 4(ANGPTL4),interleukin-18(IL-18)levels,and clinical significance in patients with rheumatoid arthritis.Methods A total of 94 RA patients treated in Baoding First Central Hospital from January 2022 to January 2024 were retrospectively selected as the observation group,and 94 healthy subjects were selected as the control group.The differences of ultrasound synovial blood flow characteristics,serum ANGPTL4 and IL-18 levels between the two groups were compared,as well as the differences of ultrasound synovial blood flow characteristics,serum ANGPTL4 and IL-18 levels of in patients with different clinical characteristics,before and after treatment in the observation group.The correlation between ultrasound synovial blood flow characteristics,serum ANGPTL4,IL-18 levels and disease activity of 28 joints(DSA28)scores was analyzed by Spearman rank correlation analysis.Results The grading of synovial blood flow characteristics in the observation group was higher than that in the control group,the levels of serum ANGPTL4 and IL-18 in the observation group were(45.50±11.02)ng/mL and(155.56±33.51)pg/mL,respectively,which were significantly higher than those in the control group[(8.10±1.02)ng/mL,(35.58±7.28)pg/mL],the differences were statistically significant(P<0.05).There were no statistically significant differences in the classification of ultrasonic synovial blood flow characteristics,serum ANGPTL4 and IL-18 levels in patients with different gender,age and body mass index(P>0.05).The classification of ultrasound synovial blood flow characteristics in highly active patients was higher than that in low-and moderate active patients,the grading of ultrasound synovial blood flow characteristics in patients with moderate activity was higher than that in patients with low activity,the differences were statistically significant(P<0.05).The levels of serum ANGPTL4 and IL-18 in highly active patients were(68.08±11.14)ng/mL a

关 键 词：类风湿性关节炎 超声滑膜血流特征 血管生成素样蛋白4 白细胞介素-18 疾病活动度 

分 类 号：R593.22[医药卫生—内科学]